Dx 2012 at age 58 ,RP(2012). G(3+4). SRT (2017) to prostate bed only with No ADT. Psa continued to rise to 1.5. Psma scan showed many small LN lesions in pelvic and abdomen. Nothing showed on usual CT&Bone scans. Started ADT(monthly Firmogon ) on 11/20 Current psa is undetectable on 11/21 Stopped ADT on 11/21. T recovered on 6/22 and psa stayed <.05 until 1/23 when it reached .05.
should I be very concern about this increase from <.05 to .05 today? It was .02 on 9/15/2021.
Thanks very much in advance for your input
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Ahk1
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I really don’t know, TA. I have 2 issues. The first one is when to resume ADT and the second issue how to monitor with imaging scans at this low psa? I am back again into this grey zone. Any ideas please on what you would do?
ingeneral speaking, what is a safe psa number to resume at? My main concern is not to die or complicate things further if I resume at a higher psa value. That is my only concern. Thanks.
It took 4 years to reach 1.5 after srt? That is slooow. How did you deal with the anxiety then?
If it were me i would wait until psa reached like 0.8 and perhaps try a psma pet. If it lights up something convenient then maybe some spot radiation and a period of adt again. (That might be like 3 years from now).
Best thing is that your cancer is appaently a slow grower. As TA said, there is no right answer so you need to follow the path that gives you the least anxiety and focus more on enjoying your life every day. Remember that tomorrow is promised to no one, so make today worthwhile.
That said, I would get a psa test every 2 months to monitor, then wait until psa hit 1.0 to do another psma scan. At that point scan might/should find the cancer. Hopefully located in a spot that can be hit with radiation and killed. Then resume the adt and stay on it for a year or more before letting your foot off the cancer cells again.
This article speaks to uPSA (ultra low) tests at the 0.05 level. There are others I have found as well on uPSA. It bothers me that in the USA treatment centers dont report less than 0.01 or in some cases now 0.04. uPSA can help diagnose progression. See my other articles on uPSA as well if they help. TNX
current treatment therapies would not normally be started at psa levels of less than 0.05 anyway. So why would anyone want to generate stress worrying about a very microscopic level of PSA increase?
Enjoy life everyday and hope the beast never grows up.
I have prostate cancer had a biopsy March 21, 2022 with a Gleason score (5+4). My PSA in February 2022 was 13.7. I was told by my urologist that I need to have my prostate removed, start ADT and possible radiation. I started a radical diet and lifestyle change removing toxins from my body, including food and personal products. I eat 100% plant-based organic fresh fruits and vegetables and drink 32 oz of fresh organic homemade fruit and vegetable juice every day. Exercise almost everyday or try as much as possible. I have been praying, asking God to help me reduce stress, learning to forgive myself from past mistakes and hurts from others. All this is taught by the three groups I mentioned. November 11th my PSA was 34, had a PSMA PET/CT scan that shows that my cancer has not metastasized and is about an inch long by less than an inch wide. I didn’t freak out is my whole point. Three weeks ago I decided to kick in more of the recommended protocol mentioned by the three groups that I follow. I increased my daily juice intake to 64oz and started doing one coffee enema a week and getting real about exercising more. I got two books to help me learn to pray better. How to pray and Prayers for Prodigals.
I radically changed my diet and lifestyle. Read my post again. Prayer is one of the major components, I believe that God will heal anyone who has faith, but must do the work.
Not true at all. I make no money off of this. I have prostate cancer and I’m sharing what has helped me. Everything I posted is FREE. If you read my comments you will see I’m in the same boat as everyone on this blog.
This is a science based group sir and we follow science that is proven and works. Your stuff is unproven and prayer and diet does not require a link to amazon therefore rendering your post useless. There are highly intelligent people that post here that require respect of their opinion.
Intelligent people are open minded and would research other healing methods. You have a closed mind, my post wasn’t for you, Move on! There’s people on here that want to heal cancer and learn about other options.
That’s how you treat a brother with the same disease as you? I joined this group to learn and help others. You’re not much of a welcoming person. I don’t treat people the way you do. I treat people with dignity, kindness and respect. You should try it.
Dude if prayer and coffee enemas give u peace of mind it's ok as long as it doesn't hurt u. Just make sure sure u follow allopathic medicine as well. I've done prayer and a smorgasbord of supplements at stage 4 , 31 psa at diagnosis, Stage M1, and I'm 10 years out. I'm on lupron and xtandi. So who's to say...?
It’s a lot more than prayers and enemas, it’s a complete diet and lifestyle change. The links I posted will go a lot deeper. It amazes me that for the month that I’ve been on this platform, nobody mentions naturopathic medicine.This site has been all about conventional medicine. The medical system has good doctors and amazing technology that I rely on but we have to think and advocate for ourselves. There are medical professionals that only do what their corporate owners tell them. There’s billions of dollars in medical care, they can’t patent natural remedies, there’s no money in it. The links that I provided will teach cancer patients how to advocate for themselves and natural remedies that strengthen the immune system. If the immune system is strong it helps heal the body and fight cancer. I’m not saying it alone cures cancer but helps fight it.
I prayed about my prostate cancer too. God told me that he will provide me with good proven treatments and that I should take those. I listened. Here I am over 6 years later.
Actually there have been studies on diet , certain supplements but like you said there's no money in this. I wouldn't advocate this as your only approach. Snergestically some seem to do better on certain diets. Fats and excess sugar drive cancer metastasis but it's hard to prove. Anyway good luck...
I only describe my situation and have no way of knowing if my treatment is appropriate for anyone else. There are some similarities between our situations. Like you I had RP in 2012, but at age 70. G=3/4. 5% in one lobe, 10% in other. All else negative. No symptoms at any time up to the present. BCR in 2016. Salvage radiation failed immediately; PSA continued to rise, with DT about 9 months. When PSA reached 0.46 just after SRT in 2016, local MO wanted to start ADT with Lupron. I declined and did not return to that practice. In a consult with Dr. Wassim Abida at MSK, he said "you did the right thing". PSA continued to rise and in 2020 reached 5.70. All routine scans negative, but G68 scan showed 2 avid thoracic nodes. Started ADT in May, 2020. Immediate drop to <0.01. 3 month scans continued <0.01 until May, 2021. Started vacation. 19 months later still on vacation, with PSA <0.01 and T = 485. Incidentally, in my consult with Dr. Abida, he informed me that the only variant I expressed is "SPOP", which he further said responds very favorably to ADT. Being followed and treated at Duke. My MO there has been recommended by TA and others. His opinion is to stay on vacation until PSA reaches 5.0 or thereabouts. In a phone consult with NIH, Mo there advised that while on vacation, to ignore DT's until PSA exceeds 0.50. Dr. George has also stated that DT is the main thing to monitor. You are likely familiar with the many posts pro and con about interrupting ADT, and also TA's and other's advice to ignore super sensitive PSA tests. I can only say that I am very comfortable with this approach; others might say I'm in denial. I have my 3 month PSA test today and see Dr. George in April.
thank you very much mangeycritter for your long. Response. Very helpful and I felt better after reading your info. I am also treated at MSK with a very good MO. what is the “SPOP” you mentioned? Is this a gene expression? Did you do the genetic analysis at MSK? They did mine but said nothing identified. Thanks again for your input. It’s just I am very nervous about this. It reminded me when I had my first recurrence. I was just starting to relax a bit and this test yesterday was not a good one.
It was several years ago and I've forgotten. Traveling until Sunday. Will look up SPOP (I think that's what it is) and send along the info. Yes, it is some variant, but don't remember if somatic or genomic. BYW, wife has been treated for meta bladder cancer by Dr. Jonathan Rosenberg. He is chief of the Kimmel Institute at MSK. He is a gem.
Found my records. Genomic test at MSK ---no mutations.
Also at MSK in July, 2019: Somatic Alterations---"SPOP Missense Mutation, F133C."
If I recall correctly, a surgical specimen is retained for 10 years.
If you haven't already seen it, suggest the Laurence Klotz report in CUAJ Jan-Feb, 2017 associating the level of free-T to time to CR and overall survival. Free-T 1.7 = 3 yrs to CR.
Time to cancer specific survival: 12, 9 and 6 yrs for the 3 groups.
Hey Brother, seeing your situation and figuring I am not far behind you I think the prudent approach would be to follow the same path we did years ago at NIH and get the PSMA scan at >.07. If something lights up then you can treat it like I did with the pelvic radiation. If nothing lights up then move back to ADT. That is my plan. I wish the best my friend.
I finished 2 years of ADT in February 2021. Been on vacation since. I have kidney disease from kidney stones now. 3 surgeries in the last couple of years. Might lose the left one and the right one needs to have stones cleaned out. On a whole new diet now to prevent further damage. If it ain't one thing it's something else.
I know how you feel, Jim. If it ain't one thing it's something else. I hope your kidney issues resolve with great outcome. I had a kidney stone about 4 months or so after the RP and the pain was just unbelievable. I am not sure if this will help but I try to squeeze lemons on my food every day now since I had that experience. Wish you the best, my friend
hi Jim, great to hear from you my friend and happy new year. psma at .6 at nih didn’t find anything. Psma at 1.5 in NY found many Mets in pelvic LN and abdomen. it was diffused disease. They never offered me radiation. I am scared to wait again untill psa climbs to 1.5 and find diffused many Mets. So I am thinking of going back to ADT when it hits .1. I have an appointment with MO on 2/7. So I will see what he thinks. The problem is, there is no clear answer or guidelines I can follow. Hope you are well aside from PC.
Maybe your M.O. will recommend another scan before you go back on ADT to determine a current state and any possible extra treatment. Regardless your PSA is so low I think you are in good shape and will be able to control it. Thinking of you my friend.
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Zoladex increase in PSA
Slow increase in PSA while on xtandi 
Continued increase in CEA & PSA Markers
Can increase in PSA in my case due to prostatitis?
